Date of Sighting day/month/year?__/__/__
Sighting Time - In the form of - Am or Pm + Time zone:__:__ __ /___
Duration - In the form of - Seconds, Minutes or Hours:________
Place of sighting - State/Province - County - City/Town - Country: _____________________________________________
Describe briefly the physical appearance of the object(s): __________________________________________________________________ __________________________________________________________________ __________________________________________________________________
Describe briefly the location of your sighting:_ __________________________________________________________________ __________________________________________________________________
What made you first notice the object?____________________________
What did you think the object was when you first saw it?__________
Describe the object and its actions:______________________________ __________________________________________________________________
How did you lose the Object?______________________________________
Name and Age:________________________________ ____________________ Town/City/State:_________________________________________
Special Training__________________________________________________ Vision:_______________
State if you are Colorblind or/and wear Eyeglasses:_______________
Hearing: Good, Fair, Poor or user Aid?____________________________
Health During Sighting:___________________________________________
Health After Sighting:____________________________________________

ENVIRONMENTAL SITUATION: SELECT AS MANY ANSWERS AS APPLY:_ ------------------------------------------------------------------------

Viewed From:_
[Outdoors] [Indoors] [Car] [Aircraft] [Boat]
[Other... explain]_ __________________________________________________________________
Viewed Through:_
[Glasses] [Window] [Screen] [Binoculars] [Telescope]
[Still Camera] [Movie Camera] [Theodolite] [Radar]
[Other.. Explain]_ __________________________________________________________________ Area/Location:_
[City] [Suburban] [Rural] [Industrial]
[Commercial] [Residential]_ __________________________________________________________________ Area/Terrain:_
[Fields] [Woods] [Hills] [Mountains] [River]
[Pond] [Lake] __________________________________________________________________ Area/Technical:
[Airport] [Powerlines] [Power Station]
[Railroad Tracks] [Other... Explain] __________________________________________________________________
Sky Condition:
[Clear] [Partly Cloudy] [Overcast] [Foggy]
[Heavy] [Medium] [Light] __________________________________________________________________ Precipitation:
[None] [Rain] [Fog] [Sleet] [Snow]
[Heavy] [Medium] [Light] __________________________________________________________________
UFO Direction:
First seen in / Last saw in / Moved from __ to __:
UFO Elevation first seen:
[1/4] [1/2] [3/4] AND [Over Horizon] or [Overhead] __________________________________________________________________
UFO Elevation last seen:
[1/4] [1/2] [3/4] AND [Over Horizon] or [Overhead]:_______________
UFO Distance when closest:_____________________
UFO Altitude when Closest to ground:______________________________
UFO passed in front of ____ Which was ___ distance from you
OR Behind ___ Which was ___ distance from you:
Also in Area:
[Airplane] [Helicopter] [Balloon] [Searchlight]
[Other ... explain] + [Before] [After] [During Sighting] __________________________________________________________________
Observed [An Object] or [A light]:________________________________
From above question: Number of, Shape of and colors of... __________________________________________________________________
Describe Sound if any:____________________________________________
Describe Smell if any:____________________________________________
Describe Speed if any:____________________________________________
Real size --
[LARGER] [SMALLER] OR [SAME SIZE] --AS--
[Basketball] [Compact car] [Standard Car] [House]
[Other.. Explain]:________________________________________________
How many time LARGER or SMALLER then the size of a star?__________
How many times LARGER or SMALLER than Moon?_______________________
Bright as [Star] [Moon] or [___ if placed same distance]:________
Did the Object(s) or Light(s) -- Choose as many as needed:
[Change Direction] [Hover] [Affect Radio/tv] [Flutter]
[Turn Abruptly] [Descend] [Affect Electricity] [Spin]
[Fall like leaf] [Ascend] [Affect Magnetism] [Blink]
[Absorb Object(s)] [Over Powerlines] [Affect Timepiece]
[Pulsate] [Eject Object(s)] [Over Building] [Affect Engine]
[Appear Solid] [Change Shape] [Land/ground] [Affect vehicle]
[Fuzzy Edges] [Cast Shadow] [Land/Water] [Affect Animal]
[Have Outline] [Cast Light] [Carry Occupants] [Affect Human]
[Wobble] [Reflect Light] [Communicate] [Affect Water]
[Vibrate] [Leave Trail] [Give Heat] [Affect Ground]
[Glow] [Disintegrate] [Leave Residue]
[Affect Vegetation] [Appear Transparent]: ___________________________________________________________________ ___________________________________________________________________
How many other witnesses?__________________________________________
Did any other agencies contact you?________________________________
Current Date: month/day/year:__/__/__


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